Diabetes Management in Aging Population: Goals, Outcomes, and Areas for Improvement

This essay discusses the goals and outcomes of diabetes management in the aging population, including controlling hyperglycemia, avoiding hypoglycemia, and improving quality of life. It also highlights areas for improvement, such as increasing awareness and improving housing options.

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Area of concern: Diabetes
The prevalent issue of concern regards diabetes diseases that constantly increases gradually as
more aging individuals live longer and growing heavier. Aging adults of the age bracket 65 years
and above having diabetes are huge risks of developing some spectrum of microvascular effects
and complications (Ahtiluoto et al,2010).Conversely, their existing tremendous risk for macro
vascular complications is sustainably enormous than for the young population. Additionally, they
are also a higher risk of developing polypharmacy, various functional disabilities, and the normal
geriatric syndromes. These complications include the growth of cognitive impairment,
nervousness, depression and a lot of incontinence urinary complications having persistent pain.
The diabetes data management in older patients differs from the dataset generated and that
acquired over a given period of time. It also differs between the old population and younger
patients.
Goals
The ultimate goals of diabetes management concern in an aging population are quite the same as
those for the young adults which involves managing goals revolving around hyperglycemia and
risk factors occurring. Evidently in weak older adults with diabetes disease, avoiding
hypoglycemia, hypotension and various therapeutic drug interactions as a result of polypharmacy
is of huge concern that their young counterparts with diabetes (Cagnacci, Boitani, Powell &
Boyce,2010). Managing the prevailing medical conditions is significant since it impacts their
capability to accomplish self-management goal for glycemic control. The risk factors
management goals ought to be based upon the patient's overall health concerns. The cognitive
functions and status literally affect the life expectancy and also risk complications.

Controlling hyperglycemia
There exist virtually no goal trials that have evaluated control of glycemic and complications that
consider more on older people thus existing fewer data generated specifically addressing
maximum glycemic goals in the overall medication that treat aging patients( Gardete‐Correia et
al 2010). The older patients with diabetes disease are a normally heterogeneous population
which include people living independently in communities.
They are usually aided by care facilities or immediate nursing homes. They can either be fit or
frail with various comorbidities and also functional disabilities. The appropriate target goal
involves correct utilization of gyrated hemoglobin (AIC) individualized depending on health
issues and life expectancy rate (Huang, Dong, Lu, Yue, & Liu,2010 It also depends on the ability
of the old patient to adopt strategies to specified treatment medication.
Unavailability of any long-term existing clinical trial data in more health old community and in
elderly individuals with less life expectancy rate, an AIC goal of less than 7%(59.1mmol/mol)
ought to be focused in medication-treated individuals. In order to achieve this particular goal,
pre-prandial level of glucose must be between 139-149 mg/LD. The glycemic goal must be a bit
higher in medication-treated for the frail older people having consistent medical and functional
comorbidities.
The improved treatment of diabetes disease in an old community is determined by the clinical
recognition and diagnosis of this particular condition. Individualized treatment goals are
normally established with the utilization of individualized therapeutic regimens (Johnston,&
Sabin,2010). The goals usually depend on lifestyle modification, for example, diet and exercise
level of the old patient as the basis for such therapeutic goals. A lot of care should be undertaken

in order to avoid therapeutic complications like hypoglycemia. The increased prevention of these
specific complications should be achieved since the elderly community is prone to high risks of
these complications. There also involves the goal of diabetes care
Individualized goals for the old patients, for instance, those frail ones who cannot be able to offer
self-care might be higher more than 8.4%. It should also comprise of increased methods to
preserve life quality, avoidance of hypoglycemia and the complications. The generated data is
more accurate.
Outcomes
Hyperglycemia usually raises dehydration levels, leads to impairment of vision and cognition. It
raises the risks of infections that lead to functional reduction and various risks of a decline in
older diabetic patients (Ling, et al, 2010).
An older patient might tolerate high-level blood glucose immediately before having much
osmotic diuresis. In addition, the side effects of treatment goals often result in relatively poor
outcomes, for example, traumatic and occurrence comorbid issues. The results of the goals to
control diabetes trial indicates that existing intensive therapy I older patients at high risks of
cardiovascular conditions contributes to the optimization of the risks and increased mortality
outcomes.
Hypoglycemia must be avoided in older patients. It is a significant approach in deciding drug
agents and proper establishment of glycemic goals. Insulin should thus be utilized with caution
in weak old adults.

Its vulnerability results to increase of hypoglycemia. Older adults have adverse outcomes such as
dizziness, weaknesses, and delirium. It results in underreporting of various hypoglycemic
episodes in the diabetic old community (Meisinger et al, 2010).
It also results in outcomes of cardiovascular events and dysfunctions. It results in the
development of high degree dementia. A mild episode of this contributes to adverse outcomes in
weak older people with diabetes. For instance, the increased episodes of being weak lead to an
increment of frail risks and more fractures
Older patients have the likelihood to develop outcomes of suffering from excess morbidity and
mortality due to minimized risks. It increases the rates of coronary heart disease (CHD) thus
causing death (Rojas & Gomes, 2013). The outcomes of the Accord trial data indicates that
having intensive glycemic therapy raises these particular risks outcomes.
If optimal glycemic goals are not met with a non-insulin agent only, use of once-daily basal
insulin in combination with a non-insulin agent can be used
There are no high-quality trial data for diabetic older patients who constantly smokes as an
independent factor to lead to CVD outcomes and increased mortality rates.
There exist few data which specifically acknowledge maximum cardiovascular risk decrease in
the old people.
They are less precise
In unavailability of complete randomized controlled trials in elderly community with diabetes
diseases, the gathered observational studies show distinct data that evaluate differences in
cardiovascular outcomes for the old patients at lower and higher HbA 1c.

The recommendation suggests a requirement for use of individualized HbA1c targets and lowers
aggressive glycemic goals for the elderly patients determined by the person's nature and health
status
Also, the generated and gathered data are distinct in that both trial results found no statistically
significant impact of glucose control on the effects (Farrell, & Petersen, 2010).
The generated data and gathered one is quite similar regarding the mortality rates and aging
population age bracket.
According to the article Farrell, & Petersen (2010) the gathered data and generated one relating
to provisions of diabetic care is similarly accurate and precise. The data show that the estimation
of a total cost of diagnosed conditions of diabetes has risen to $245 billion in the United States in
the year 2012. They also indicate an overall coverage gap that decreases over the years (Shaw,
Sicree, & Zimmet, 2010).
Both data indicate that older patients have 3 times prevalence rates of this condition as compared
to young population discharged in the hospital setting in the U.S
Result data from the studies should that the rate of severe hypoglycemia is still high among those
old patients with 2 or more comorbidities at 3 per 100 people. It raises concerns that older
patients with several comorbidities are more vulnerable to dangerous glycemic conditions.
Strengths of the elder community
A maturing populace is related to fewer kids. Another preferred standpoint featured thus, is cost
funds related with taking into account fewer kids and youngsters in the economy. This would

result in lower state-funded training cost, bring down human services cost and other social
projects given to kids by the Government
More established individuals or the older population have lived longer, subsequently are more
experienced than more youthful individuals. A maturing populace can be invaluable for this
situation, utilizing their experience to help maintain ethics and qualities in a nation,
An expansion in the extent of elderly people in the populace prompts a developing pool of
volunteers in the economy. This has been distinguished as a worldwide preferred standpoint
where the elderly contribute free work to network and government extends after retirement
The acquire health benefits like free treatments
Weakness
The aging community is less productive in the job sector. There is also optimized pension and
health care incurred costs. Therefore it results to high dependency rate and a high cost of health
amenities and taxes.
The older community is progressively inclined to sicknesses and illnesses; in that capacity, an
expanding number of wiped out people will put weight on medicinal services offices, which
probably won't have the capacity to adapt to the interest. Diabetes, hypertension and malignant
growth improve in probability with age (Slavin, Brodaty & Sachdev, 2013).
It leads to more competition for jobs due to extended retirement age for the old people
Areas that need improvement
The areas that require some improvements in the elderly patient's community include increasing
the quality of life which is significant for health.

It's insufficient to simply be alive. Great personal satisfaction is particularly essential for a more
established older population. Feeling fulfilled and satisfied is similarly as critical as getting
normal registration from the specialist.
Treating their depression
Dejection late in life really influences 6 million individuals age 65+. It could be caused by
unpleasant life occasions like retirement or losing a life partner. It could likewise be caused by a
therapeutic sickness or prescription reactions
Physical activities
Standard physical movement, regardless of how mellow, helps keeps both body and mind feeling
adjusted and positive. Therefore recommendations on strategies to improve physical exercise
areas should be done. Old patient's fitness clubs should be designed in order to improve their
health conditions and prevent risks of diabetics (Whiting, Guariguata, Weil, C., & Shaw, 2011
Exercise keeps blood streaming to the cerebrum, honing the psyche. It additionally calms
nervousness, strain, and even misery! By and large, it just improves individuals feel. It this
improves the health of the older people. Physically, practice helps the insusceptible framework,
brings down pulse, enhances rest quality, enhances heart wellbeing, enhances quality and
stamina, and that's only the tip of the iceberg
Recommending on increased awareness and improvement of existing services
Members expressed that data identified with cost, qualification criteria and contact data was
required on seniors' lodging, medicinal services administrations, open transportation, health care

coverage inclusion and home consideration. Health centers and care services for the old
community should be created.
Improving housing options
Members communicated the need to have efficient seniors' housing for various dimensions of
consideration, formal registration, closeness downtown, dinner alternatives, and a typical space
to help social cooperation.
Safety areas and mobility friendly environments
Some of the recommendations that involved improving safety and more conducive environments
for the elderly community featured the significance of safe walkways and streets, programmed
entryways, incapacitate parking spots and stair inclines.
Health training and awareness programs
These were done in order for the old to understand their health conditions
Improve Neighborhood financial status—frequently estimated by middle family unit salary or
the offer living beneath the destitution line—is a standout amongst the most generally considered
and most grounded indicators of the wellbeing and prosperity of more established grown-ups
(Whiting, Guariguata, Weil, & Shaw, 2011). More seasoned occupants of financially distraught
neighborhoods are bound to have interminable wellbeing and versatility issues and kick the
bucket at more youthful ages contrasted and more seasoned inhabitants in increasingly wealthy
networks.

The dimension of pay disparity in a neighborhood likewise impacts well-being. Utilizing the
gathered data from the data looks at wellbeing results of grown-ups ages 50 and more established
with comparative financial profiles in high-disparity and low-imbalanced U.S. areas.
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